Sylvan's numbers

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sylvan

sylvan

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Hello all,

So I'm confused by Sylvan's numbers and wondering if anyone has some advice. Although we are seeing a drop after his doses, he is only coming down into the 200's. Yesterday we tried a little heavy on the prescribed 3 units and he stayed pretty high all day. Today we went to 2 1/2 units and although he was lower, he's still not at a good place.

I spoke to my vet about a dose change and he said the 200's are what we should aim for and cats are just hard to regulate, which left me completely frustrated. He also said it was probably the Fancy Feast (low carb flavors) and we should stick with DM, which Sylvan hates.

Any advice? Should I raise his dose, keep at a light 3.0, or do a full 3.0 units? And of course, ketones are a concern. I was able to do one ketone test and it might have shown trace ketones - not sure. I tried to do another test and he wouldn't have it. Going to try the aquarium rock litter box trick next.

Thanks,
Liz
 
Hi Liz,

I know you have been reading so you know your vet is wrong about the numbers. Many cats are able to be regulated with preshot numbers in the low 300s and nadirs in the 100s; lots of cats are able to get off insulin entirely. And many cats won't eat the DM - it is heavy liver and I think the taste gets old. My theory is that your vet isn't there to see what you feed your cat, so you can feed him what he will eat and what you can afford and try to stay under 10% carbs.

You have several choices - you can raise the dose and see whether you get any lower numbers. You did start higher than we usually suggest and so he may be rebounding: Rebound The tricky thing about doing a rebound check (either going down to one unit for a few cycles or cut your dose in half to 1.50) is the ketone issue. You have to be very careful with a ketone sensitive kitty when reducing the dose - just in case you are going the wrong direction.

If I were you, I might do some heavy duty ketone testing for the next day or so (yes, we used the aquarium gravel and it was the only way we ever got a sample) to make sure he is ketone free. When you are sure about that, I would try the rebound test - but only for a few cycles and testing for ketones the whole time.

Any thing else that might be interfering? Infection? Bad teeth? High carb treats? Any chance he gets into dry food?
 
Hi! was Sylvan just diagnosed in January? I see on his spreadsheet that he is prone to ketones, so if you think you are seeing even a trace on the strip please make sure he is eating and drinking plenty. Aside from the proper dose of insulin, those are the 2 most important things to flush the ketones. Did Sylvan start at 3u? I'm sure I'm not the only one who will think that that is way too high of a dose to start with. But lowering it back could be dangerous when kitty is prone to ketones. I'm sure some veterans will be along soon with some good tips about that. We generally recommend that you start at 1u twice a day. Even that is too much for many kitties (see KristenP&Sam 's spreadsheet for an example of that). So dropping back may be the best idea, but you should be adding some water to his wet food and testing very regularly for ketones when you do it. It is quite possible that the flat numbers are because he is being overdosed. But it could also mean that he just needs more insulin. The low-carb fancy feast is much better for diabetics than the d/m. It's much lower in carbs...but your vet doesn't make any money when you buy fancy feast :lol: so, they try to sell you the d/m. Mine does it too.
I hope this helps some. Keep asking questions!
 
Thanks so much. Yes, I'm scared to do the rebound test, but I'll feel more confident when I get the hang of ketone testing. I may try a 1/4 unit higher tomorrow, since we'll be home.

We don't have dry food in the house, and no treats. But he is constantly hungry and I do feed him throughout the day, so that may be at play too. His teeth have some tarter, but I don't think they're infected. But I'll ask on the next vet visit.

My other theory is that his body may be so used to having sugar in the 200's that it is keeping it there. Does that make any sense?
He has been a hoover since we first brought him home as a young cat. Always starving...so maybe he has had high sugar for a while?

The good thing is he's definitely more like himself, playing and meowing. He lost his meow before and he was a very vocal cat.
 
To Charliemeow :

Thanks and yes, the vet started him on 3 units on January 8. He was at the hospital for 4 days with ketones. I'm not sure if it was full DKA, but he was in pretty bad shape. Not eating, not drinking, very lethargic. The vet said he started low and raised the dose every day until he sent him home on 3 units, twice a day.

Thanks for the advice about adding water to the food to keep him hydrated. I really appreciate it.
 
Sylvan is a very handsome kitty. My Charlie is also a Hoover and a talker. How often and how much do you feed Sylvan? I think it's totally possible that his body just keeps dumping glucose to keep it feeling "normal". That's what I'm pretty sure is going on with Charlie (up to 7.5 u twice a day trying to break through that resistance). The liver feels the sugar starting to drop and says "oh, no!" and dumps glucose. It can get pretty frustrating. But there is a saying here that this is a marathon, not a sprint.

So the vet started lower. That's kind of good, but most cats experience stress at the vets so their glucose levels are quite a bit higher there then they would be at home. Just something to keep in mind...
 
It is always good to hear that he is more like himself. That part is very important!

Unregulated kitties do tend to be always hungry - their bodies are not processing the food well. So we tell newbies to go ahead and feed them. Oliver was way too heavy all his life (of course because we were feeding Science Diet Lite :evil: ) When we first started this journey, he was up to 3 cans of Fancy Feast daily. After he got regulated and off the juice, we went back to 2 cans and his weight was normal from then on. And it is often a good idea to free feed if you can. Just leave the food out and let him graze so it helps to even out his glucose levels. You can freeze it and let it thaw or you can get an automatic feeder to help with that process.

So if Sylvan needs to gain, I would feed him what he wants. If he needs to lose, I would feed him more than I might usually, knowing you can taper it off once he is regulated better.

I agree with Claudia that the problem with the vet starting low and then increasing the dose at the hospital is that stress raises bg levels. So in the hospital, not feeling well with lots of strange noises and smells and people, it is likely that Sylan's numbers were much higher than if tested when not under stress. So it may not have been a true test of how much he really needs. At that point, the vet was probably trying to get the numbers down and rightfully so, but the picture may be much different once Sylvan gets home.
 
I've just started doing some things I've seen others post about in here: Tuna water, keeping the food really moist (often with the tuna water), and freezing baked chicken breast for treats and to leave out over night.

Bud was dehydrated 11 days ago and had an infection and high temp. She loves the tuna water and will often just lick the 'juice' off her food. The water and the 'wet' wet food really has made a difference.
 
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